Metabolic Transformations of Cortisol-4-[14C] in Human Skin

in Human Skin and Vaginal Mucosa**From the Departments of Dermatology and Biochemistry, University of Miami School of Medicine, Miami, Florida 331...
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Metabolic Transformations of Cortisol-4-["C] in Human Skin" S. L. Hsia and Yu-Lee Hao

ABSTRACT: Cortisol-4-[ l e ] was found actively metabolized by slices of human skin. By paper chromatography, isotopic dilution, and the preparation of acetates, the following metabolites were identified: cortisone, Ad-pregnene-11&17cr,2Op,21-tetraol-3-one (Reichstein's substances E), A4-pregnene-1lp-17cu,20a,21-tetraol-3one (epi-E), A4-pregnene-17a-2OP,21-triol-3,1l-dione (U), and A4-pregnene-17a,20a,21-triol-3,1 1-dione (epi-

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previous communication from this laboratory presented evidence of active metabolism of cortisol4-[lC] by slices of human skin (Hsia et al., 1964). Several metabolites were detected by paper chromatography; it was also noticed that one of the peaks of radioactivity in the paper chromatogram was characteristic of the metabolism of foreskin and was not detected after incubation with skin of other anatomical sites. That the metabolism is linked to the pyridine nucleotides was demonstrated in a subsequent study Wsia et ul., 1965) in which skin specimens obtained at autopsy were found to have lost their ability to metabolize cortisol, but the metabolism could be restored by the addition of TPNH1 or DPNH to the incubation medium. In the same study it was found that both the dermis and epidermis are capable of metabolizing Corti-

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* From the Department of Biochemistry and Department of Dermatology, University of Miami School of Medicine, Miami, Florida. Received November 22, 1965; revised February 2, 1966. A preliminary report of this work was presented at the meeting of the Federation of American Societies of Experimental Biology in Atlantic City, N. J., April 1965. This investigation was s u p ported by Career Development Award l-K3-AM-28,095, grants (AM-09497 and AM-07138) from the National Institute of Arthritis and Metabolic Diseases of the National Institutes of Health, U. S. Public Health Service, and by funds of the Dermatology Foundation of Miami. 'The following abbreviations and trivial names are used: TPN+ and TPNH, oxidized and reduced triphosphopyridine nucleotide; DPNH, reduced diphosphopyridine nucleotide ; cortisol, Ad-pregnene-1lp,17a,21-triol-3,20-dione;cortisone, A L pregnene-17a,21-dio1-3,11,20-trione;allodihydrocortisot. Sa. pregnane- llp,17a,2l-triol-3,20-dione; allotetrahydrocortisol, Sapregnane-3a,11,9,17a,21-tetraol-20-one; dihydrocortisol. SB-pregnane-l1~.17a,21-triol-3,20-dione;tetrahydrocortisol (THF), 5p-pregnane~3a,ll~,l7a,2l-tetraol-20-one: tetrahydrocortisone Reichstein's (THE), 5,9-pregnane-3a,17a,2l-triol-l1,20-dione; substances E, A cpregnene- 1 lp,17a,20&2 1-tetraol-3-one; epi-E, A 4-pregnene-1 1&17~,20a,21-tetraol-3-one ; U, A cpregnene- 17a,20&21 -triol-3,ll-dione ; epi-U, A '-pregnene- 17a,ZOa,21-triol3,ll-dione.

U), allodihydrocortisol, and allotetrahydrocortisol. The latter two steroids were found only after incubation of cortis014-[~4C]with foreskin and not with skin of other anatomical sites. The two general pathways of metabolism of cortisol in human skin appear to be oxidation of the llp-01 and reduction of the 20-one while saturation of the Ad-double bond and reduction of the 3-one appear limited to the foreskin.

In a continuation of these studies, several metabolites have now been identified, including cortisone and Reichstein's substances E, epi-E, U, and epi-U. Allodihydrocortisol and allotetrahydrocortisol have been found, so far, only after incubation of cortisol with foreskin; their formation after incubation with skin of other anatomical sites could not be established. The evidence for the identification of these metabolites is reported in this paper. Experimental Section and Results

Materials. Cortisol-4-[ I C ] with specific activity of 22.5 mc/mmole was purchased from Nuclear Chicago. The material was purified before use by paper chromatography in the system of methanol-benzene-waterethyl acetate (1 :1:1 :O.l) as described by Fukushima et al. (1 960). Tetrahydrocortisol and tetrahydrocortisone were gifts of the Merck Institute of Therapeutic Research and allotetrahydrocortisol, a gift of G. D. Searle and Co. The other steroids used were purchased from Mann Research Laboratories, Inc. Foreskin specimens were collected at circumcision and specimens from other anatomical sites were obtained at surgery or at autopsy 16-20 hr postmortem. Incubation and Analysis. Details of the procedures were reported previously (Hsia et al., 1964, 1965). The skin specimens were cut free hand to small pieces weighing 25 mg or less, and ca. 400-500 mg were incubated in 5 or 7 ml of Krebs-Ringer phosphate buffer (pH 7.4) with cortis014-[~4C] containing 106 dpm of l4C dissolved in 0.1 ml of ethanol. I n experiments with cadaver skin a TPNH-generating system was added to the medium, consisting of TPNf (1 pmole), glucose 6-phosphate (5 pmoles), and glucose 6-phosphate dehydrogenase (1 Kornberg unit). After 4-5 hr of incubation at 37 O , the radioactive materials were extracted with methylene chloride with 9 4 9 8 x recovery and analyzed by paper chromatography in the

METABOLIC TRANSFORMATIONS OF

C O R T I S O L - 4 - [ 14C]IN

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1: Chromatographic behaviors of radioactive metabolites. The radioactive metabolites obtained after incubation of cortisol-4-['C] with human foreskin were chromatographed together with four reference steroids: cortisone (E), cortisol (F), tetrahydrocortisone (THE), and tetrahydrocortisol (THF). The distribution of "C was traced by a n autoscanner and the reference steroids were visualized by staining with blue tetrazolium. PICURE

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system of methanol-benzene-water-ethyl acetate (1 : 1 :I :0.1) (Fukushima e f al., 1960). For determinations of specific activity, between 300 and 700 pg of the crystals was weighed on a Cahn gram electrobalance and the radioactivity of the sample assayed with a Tri-Carb liquid scintillation counter, Model 314EX. The efficiencyfor counting '4C was 43 %. Chromatographic Behaviors of Mefabolites. In an exploratory experiment for possible identification of the metabolites, ca. 200 pg each of cortisone, cortisol, tetrahydrocortisone, and tetrahydrocortisol were chromatographed together with the radioactive metabolites obtained after incubation of cortis01-4-['~C] with foreskin. The distribution of radioactivity was traced with a Vanguard autoscanner 880. The locations of the four reference steroids were visualized by staining with a 0.27? solution of blue tetrazolium in 10% NaOH. Figure 1 is a photograph of the results. The tracing exhibits seven distinct peaks which are designated with Roman numerals in order of decreasing mobility. Peak I, which is immediately behind the solvent front, probably indicates decomposition products of cortisol4-['C]; in experiments with freshly purified cortisol4-[*4C],peak I was found to diminish in size. A faint stain with blue tetrazolium is also observable in this area, indicating decomposition products or impurities of the reference steroids. Peak 11 is similar to the mobility of cortisone (E), peak I11 to that of cortisol (Fl, and peak V to that of tetrahydrocortisol (THF). Tetrahydrocortisone (THE) has chromatographic mobility between peaks 111 and IV. Peak VI indicates a metabolite which is more hydrophilic than tetrahydrocortisol. The significance of peak VI1 is not clear as its size varies from experiment to experiment. The tracing shown in Figure 1 is typical of the results obtained after incubation with foreskin. Of the many specimens of foreskin examined, including more than 20 from the newborn, three from prepubertal boys (ages 9, 11, and 13), all produced similar chromatograms in which peak IV was obvious. In experiments with skin from other anatomical sites, including the thigh, the arm, the neck, the abdominal wall, and the sole from both sexes of ages from 5 months to 92 years, peak IV was not apparent while the other peaks were comparable to those in Figure 1. Exemplifying chro-

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matograms were published previously (Hsia ef al., 1964,1965). Idenrification of Unn?embnIized Corti~ol-C['~CJ. The radioactive material from the center of peak 111 was eluted off the paper and an aliquot containing 2.95 X IO5 dpm was diluted with 23.7 mg of carrier cortisol to give a calculated specific activity of 451 dpm/pmole. The mixture was dissolved in cu. 2 ml of a mixture of methanol and methylene chloride; crystallization was brought about by the gradual addition of hexane. After the crop of crystals ceased to increase, the mother liquor was carefully decanted and the crystals were washed with hexane. The crystallization was repeated and the crystals were then dried to constant weight under vacuum at 60". A small sample of the dried crystals (408 pg) was weighed and assayed for 'Cand the specific activity was found to be 451 dpm/&mole. After two subsequent crystallizations from a mixture of acetone, benzene, and hexane, the specific activity was 444 dpm/pmole. The crystalline cortisol (12.4 mg) was then acetylated with a mixture of 0.5 ml of pyridine and 0.5 ml of acetic anhydride. After two crystallizations from a mixture of methylene chloride, acetone, and hexane and two more crystallizations from a mixture of acetone, methanol, and hexane, the specific activity of cortisol acetate remained constant at 448 dpm/wmole. Comparison of the calculated specific activity with the observed values indicates that practically all the radioactive material examined could be unmetabolizrd cortisol-4-[~C]. In more than 50 experiments, the amount of I C in peak 111 was 85-90% of the chromatographed radioactivity, indicating I&l57? of the labeled steroid could have been metabolized and were distributed among the other peaks. Identificarion of Metabolites. The amounts of I C in the other peaks were estimated by a Vanguard autoscanner 880 with automatic data system and expressed in percentage of the chromatographed radioactivity. Results of the many experiments were in the following ranges: peak II,3-8 %; IV, 1-1.5 7? (with foreskin only); V, 1-1.5Z; and VI, 1-27?. The radioactivity in each peak was eluted with methanol. The eluates of the same peak from several paper strips were pooled and chromatographed once

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more in the above described system. Aliquots of the rechromatographed radioactive materials were diluted with carrier steroids. The specific activities were determined and the acetates prepared in the same manner as in the identification of the unmetabolized cortisol. PEAK11. In the examination of the 14c in peak I1 obtained from the incubations with foreskin it was found that 50.6% of the 14C could be in cortisone. In addition, 46% of the l4C could be in allodihydrocortisol. The details of determination of the specific

TABLE I : Identification

of Cortisone.@ SP Wt of Activ of Crystals (dpm/ Crystn (mg) pmole) No.

Solvents ~

Cortisone Methanol-hexane Acetone-hexane Acetate Methylene chloride-hexane Acetone-hexane

2 2

18 4 16 3

270 270

4 2 2

10.5 7.5 4 0

174 155 159

a Cortisone (21.7 mg) was added to an aliquot containing 1.88 x 1 0 4 dpm of l4C from the area of peak I1 after the incubation of cortis01-4-[~4C]with foreskin. The calculated specific activity was 312 dpm/pmole. These data indicate that 50.6% of the '4C examined could be in cortisone.

activities of these two compounds and their acetates are shown in Tables I and 11. of peak I1 from the incuIn an experiment with bation with skin of the abdominal wall, the amount of 14C in cortisone was found to be 73%. Although the data in Table I1 established the formation of allodihydrocortisol as a metabolite of the foreskin, formation of this compound in skin of other anatomical sites could not be demonstrated. In one experiment, allodihydrocortisol (31.2 mg) was added to an aliquot of the 14C (3.54 X I O 4 dpm) from peak I1 of a chromatogram obtained from a study with skin of an amputated leg. The calculated specific activity was 414 dpm/pmole. The specific activity decreased after repeated crystallizations and further decreased after the preparation of the acetate. A value of 15 dpm/pmole was obtained after the last crystallization. The experiment was repeated with 22.3 mg of allodihydrocortisol and 5870 dpm of 1 4 c from peak I1 obtained in an experiment with skin of the abdominal wall. The calculated specific activity was 96 dpm/pmole. The observed specific activity declined after several crystallizations. It declined to 10 dpm/pmole after the preparation of the acetate and then to 7 dpm/pmole after the last crystallization. The 5P-isomer, dihydrocortisol, also has chromatographic mobility corresponding to peak TI. In repeated experiments with skin from several sites, its presence as a metabolite could not be demonstrated. PEAKIV. The identification of allotetrahydrocortisol with the radioactive material in peak IV is supported by data present in Table 111. The data indicate that

TABLE 111: Identification

TABLE 11: Identification

of Allodihydrocortisol:

Solvents Allodih ydrocortisol Methylene chloridemethanol-hexane Acetone-methanol-hexane Methylene chloridemethanol-hexane Acetone-methanol-hexane Acetate Acetone-methanol-hexane

SP No. Wt of Activ of Crystals (dpm/ Crystn (mg) pmole)

1 2 2 2

29.7 22.5 16.5 15.6

366 334 305 299

1

8.3

304

1 1

3.7 2.0

295 300

a Allodihydrocortisol (63.4 mg) was added to an aliquot containing 1.14 X lo5 dpm of lC from the area of peak I1 after the incubation of cortis01-4-[~4C] with foreskin. The calculated specific activity was 652 dpm/pmole. These data indicate that 46% of the 4c examined could be in allodihydrocortisol.

Solvents Allotetrah ydrocortisol Methanol-hexane Acetone-hexane Methanol-hexane Diacetate Benzene-hexane

of Allotetrahydrocortisol:

No. of Crystn

Wt of Crystals (mg)

SP Activ (dpm/ pmole)

1 1 1

17.0 13.3 9.4

261 253 251

2 1

5.6 4.2

246 249

a Allotetrahydrocortisol (25.6 mg) was added to an aliquot containing 2.22 X lo4 dpm of from the area of peak IV after the incubation of cortis01-4-[~4C] with foreskin. The calculated specific activity was 318 dpm/pmole. These data indicate that 78% of the l4C examined could be in allotetrahydrocortisol.

78 of the '4C examined could be in tetrahydrocortisol. PEAK VI. An aliquot containing 4.10 X lo4dpm from peak VI in 10 ml of methanol was treated with 25 mg of

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HI04.2H20 in 1 ml of 0.1 N H2S04.The mixture was kept at room temperature overnight and was then diluted with water and extracted with ether. The extracted 14C (3.80 X l o 4 dpm) was mixed with 50 pg of A4-androsten-llp-ol-3,17-dione and subjected to paper chromatography. The majority of the was found in the area of peak I together with the reference steroid which was visualized under ultraviolet light. After elution from the paper, 3.04 x l o 4 dpm was diluted with 26.8 mg of Ad-androsten-1lp-ol-3,17-dione. The specific activity remained constant at 281 dpm/pmole after repeated crystallizations. The data indicated that 83% of the 14C examined could be in A4-androstenllp-ol-3,lir-dione. The radioactive metabolite apparently was oxidized by periodic acid to form A4-androstene-1lP-ol-3,17dione by scision of the side chain, giving evidence that the metabolite has the same nucleus as cortisol, and that the metabolic change was in the side chain. Reduction of the 20-one to form the 20-01s (Reichstein’s substances E and epi-E) was a distinct possibility. Consequently aliquots from peak VI were diluted with Reichstein’s substances E and epi-E. Tables IV

TABLE IV:

TABLE

v: Identification of Reichstein’s epi-E.a SP No. Wt of Activ of Crystals (dpm/ Crystn (mg) pmole)

Solvents Reichstein’s epi-E Methanol-acetone-hexane Diacetate Acetone-hexane Methylene chloridemethanol-hexane Acetone-hexane

18.5 16.5

514 519

2 2 2

10.8 10.0 9.2

264 252 235

4

6.8

237

a Reichstein’s epi-E (19.7 mg) was added to an aliquot C from the area of containing 4.98 X 104 dpm of I peak VI after the incubation of c ~ r t i s o l - C [ ~ Cwith ] skin of the abdominal wall. The calculated specific activity was 921 dpm/pmole. These data indicate that 26% of the 14C examined could be in Reichstein’s substance epi-E.

Identification of Reichstein’s E.

Solvents

Wt of No. of Crystals Crystn (mg)

Reichstein’s E Acetone-hexane Diacetate Benzene-hexane Acetone-hexane

SP Activ (dpm/ pmole)

4 1

21.8 19.9

278 265

2 2 2

9.6 7.7 6.0

234 231 227

Reichstein’s Substance E (24 mg) was added to an aliquot containing 2.12 x lo4 dpm of ‘4C from the area of peak VI after the incubation of cortis01-4-[~4C] with skin of the abdominal wall. The calculated specific activity was 323 dpm/pmole. These data indicate that 70% of the 14C examined could be in Reichstein’s substance E.

hydrocortisol to give a calculated specific activity of 207 dpm/pmole. The material was crystallized repeatedly and the specific activity declined. After the preparation of the acetate, the specific activity further declined and a value of 8.8 dpm/pmole was obtained after the last crystallization. Thus the presence of tetrahydrocortisol in peak V could not be established.

TABLE VI: Identification

of Reichstein’s U:

and V show the specific activities of the two compounds after repeated crystallizations and after the formation of their acetates. The data indicate that 70% of the 1 4 c examined could be in substance E and 26% could be in epi-E. PEAKv. Tetrahydrocortisol which is a major urinary metabolite of cortisol has chromatographic mobility similar to that of peak V (Figure 1). Its presence in peak V was examined. An aliquot containing 1.59 X 104 dpm from peak V was diluted with 28.2 mg of tetra-

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Solvents Reichstein’s U Ether-methanol-acetonebenzene-hexane

Benzene-rnethanol-etherhexane Diacetate Acetone-methanolbenzene-hexane Methylene chloride-hexane Acetone-hexane

2

19.6

152

2

17.3

153

2

8.3

69.2

2 2

5.2 4.4

62.3 62.0

Substance U (23.2 mg) was added to an aliquot containing 1.59 X l o 4dpm of from the area of peak V after the incubation of cortis01-4-[~C]with skin of abdominal wall. The calculated specific activity was 249 dpm/pmole. These data indicate that 25% of the lC examined could be in Reichstein’s substance U. 0

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CHZOH

I

I

c=o

&-OH

___, CI H 2 0 H

0)

04

@-+

,.,

HO.'

H

-

A I lodi hydro cortisol

c=o

&-OH

AI Iot e t r a hydro

-

cortisol

CH20H

CHEOH

I

I

HC - OH

HO-CH

C o r t i sol

1 1

CH2OH

Ob

&OH

+

0 4&-OH Reichstein's epi

Reichstein's E

CH20H

CH20H

I

I

0

-E

HC -OH

+

4&O !H

C o r t i sone

+ '0&-OH

Od Reichstein's U

Reichstein's epi -U

FIGURE 2 : Metabolic transformations of cortisol in human skin. Formation of allodihydrocortisol and allotetrahydrocortisol has been confirmed only in foreskin. Oxidation of 1ID-01 and reduction of 20-one are common to skin of all anatomical sites studied.

Since Reichstein's E and epi-E were identified as metabolites in peak VI, the possibility of their 11-keto homologs, namely Reichstein's substances U and epi-U, being in peak V was tested by isotopic dilution. Tables VI and VII present the results which indicate that 26% of the l4C examined could be in substance U and 1 4 Z could be in substance epi-U. Discussion The identification of cortisone as a major metabolite of cortisol in human skin confirms an earlier observation by Malkinson et al. (1959), who reported the formation of a compound with chromatographic mobility similar to that of cortisone after incubation of cortisol with human skin. Oxidation of the 110-01 of cortisol to form cortisone seems to be a common pathway in the metabolism of cortisol. It has been demonstrated in rat liver (Schneider and Horstmann, 1952; Hurlock and Talalay, 1959), in rat kidney, and other tissues (Hurlock and Talalay, 1959; Mahesh and Ulrich, 1960; Berliner et al., 1958; Ganis et al., 1956), and in human placenta (Osinski, 1960). Cortisone has also been identified as a minor urinary metabolite of cortisol in man (Fukushima et al., 1960; Burstein et al., 1953). The other metabolites identified in this study are the 20-01s: Reichstein's substances E, epi-E, U, and epi-U. The two ~OP-OIS,E and U, were previously reported as

ME1 ABOLIC

metabolites of cortisol in eviscerated rats (Berliner et al., 1958) and in cultured human fibroblasts (Sweat et a[., 1958). The 20a-01 epi-E was identified as a metabolite of cortisol in loose connective tissue of the rat (Berliner and Dougherty, 1958). In the present study the two 200-steroids were found in greater amounts than their 20a-epimers. Whether one or more enzymes are responsible for their formation awaits further investigation. It is of interest that allodihydro- and allotetrahydrocortisol are metabolites of the foreskin but their formation could not be established after incubation of cortisol with skin of other anatomical sites. This metabolic difference is an example of the biochemical heterogeneity of the skin. The results of this study may be compared to those of a study with eviscerated rats (Berliner et al., 1958), in which cortisol was converted to a number of metabolites including cortisone, Reichstein's E and U, A4androsten-lI/3-01-3,17-dione,and 5/3-dihydrocortisol. In the present study no 50-steroid was detected among the metabolites, in contrast to the results of the studies with eviscerated rats (Berliner et al., 1958) and rat liver (Gold and Garren, 1964). The lack of 50-reductase in the skin is also in marked contrast with systemic metabolism where 5/3-steroids constitute the major urinary metabolites of cortisol in man (Fukushima el al., 1960; Peterson et al., 1955; Nadel, 1956).

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TABLE VII : Identification

of Reichstein's epi-U." SP Wt of Activ of Crystals (dpm/ Crystn (mg) pmole)

E, epi-E, U, and epi-U have not been found in the urine, these skin metabolites may well be further metabolized to form the cortols and cortolones which are excreted in the urine.

No.

Solvents Reichstein's epi-U Acetone-benzenemethanol-hexane Diacetate Acetone-hexane Methylene chloride-hexane Acetone-hexane

3 7

22.0 16.1

40.6 41.3

2 2

14.9 10.3 9.2 8.4

42.0 39.5 35.9 34.1

2 2

Reichstein's epi-U (24.2 mg) was added to an aliquot containing 1.59 X lo4 dpm of I C from the area of peak V after the incubation of cortis01-4-[~4C]with skin of abdominal wall. The calculated specific activity was 239 dpm/pmole. These data indicate that 14P;: of the 14C examined could be in Reichstein's substance epi-U. a

Since less than half of the lC in the area of peak V could be accounted for by Reichstein's U and epi-U, and the significance of peak I and peak VI1 has not been investigated, other metabolites of cortisol in the skin yet remain to be identified in further studies. The results of the present study, nonetheless, have established the major metabolites and suggest that oxidation of the 110-01 and reduction of the 20-one constitute the two general pathways of metabolism of cortisol in human skin. A third pathway which so far has been found only in the foreskin is the formation of allodihydro- and allotetrahydrocortisol. These transformations may be summarized as in Figure 2. Since skin is one of the largest organs of the body, its contribution to systemic metabolism may be significant. Transport of cortisol to and from the body surface through the skin has been demonstrated. After topical application of cortisol-4-[ 4C] to human subjects, small amounts of 14C were detectable in the urine (Malkinson and Ferguson, 1955), and I C was found in skin surface lipids following intravenous administration of cortisol4-['4C] (Cook and Spector, 1964). Whether cortisol is transported through the skin unchanged, partially, or totally metabolized has not been studied, but it is likely that cortisol as well as the skin metabolites can enter the general metabolic pool. Since Reichstein's

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Acknowledgments We wish to express our thanks to Dr. Robert Silber of Merck Institute for Therapeutic Research for making available to us samples of tetrahydrocortisol and tetrahydrocortisone and to Dr. James Ahlberg of G. D. Searle and Co. for a sample of allotetrahydrocortisol. We are indebted to Mr. Roger Richard for his able technical assistance throughout this work. References Berliner, D. L., and Dougherty, T. F. (1958), Proc. SOC.Exptl. Biol. Med. 98, 3. Berliner, D. L., Grosser, B. I., and Dougherty, T. F. (1958), Arch. Biochem. Biophys. 77, 81. Burstein, S., Savard, K., and Dorfman, R. I. (1953), Endocrinology 53, 88. Cook, T. J., and Spector, A. R. (1964), J. Invest. Dermatol. 43, 413. Fukushima, D. K., Bradlow, H. L., Hellman, L., Zumoff, B., and Gallagher, T. F. (1960), J. Biol. Chem. 235,2246. Ganis, F. M., Axelrod, L. R., and Miller, L. L. (1956), J. Biol. Chem. 218, 841. Gold, N. I., and Garren, L. D. (1964), J . Biol. Chem. 239,2796. Hsia, S. L., Mussallem, A. J., and Witten, V. H. (1965), J . Invest. Dermatol. (in press). Hsia, S. L., Witten, V. H., and Hao, Y . L. (1964), J . Invest. Dermatol. 43, 407. Hurlock, B., and Talalay, P. (1959), Arch. Biochem. Biophys. 80, 468. Mahesh, V. B., and Ulrich, F. (1960), J. Biol. Chem. 235,356. Malkinson, F. D., and Ferguson, E. H. (1955), J . Invest. Dermatol. 25, 281. Malkinson, F. D., Lee, M. W., and Cutukovic, I. (1959), J . Invest. Dermatol. 32, 101. Nadel, E. M. (1956), Arch. Biochem. Biophys. 61, 144. Osinski, P. A. (1960), Nature 187, 777. Peterson, R. E., Wyngaarden, J. B., Guerra, S. L., Brodie, B. B., and Bunim, J. J. (1955), J . Clin. Invest. 34,1779. Schneider, J. J., and Horstmann, P. M. (1952), J. Biol. Chem. 196,629. Sweat, M. L., Berliner, D. L., Swim, H. E., Nabors, C . J., Jr., and Dougherty, T. F. (1958), Biochim. Biophys. Acta 28, 591.